SMARTSHOPPER.NET CREDIT CARD GUARANTEE FORM ATTENTION: SmartShopper Officer: ________________ Fax: +63-2-895-5567 This is to authorize Infophil Inc/ ____________________ to debit the total amount of ____________________________________________________________________ (exact amount in words) US$ _________ against my credit card as payment for my order described below (PLEASE FILL UP THE BOX BELOW) -------------------------------------------------------------------- | | | | | | | | | | | | --------------------------------------------------------------------- MY CREDIT CARD DETAILS ARE AS FOLLOWS: Name printed on card: __________________________________________________________ Credit Card Number: ____________________________________________________________ Expiry Date: ___________________________________________________________________ Issuing Bank: __________________________________________________________________ 3-Digit Credit Card ID Code (found at the back for VISA or MASTERCARD): ________ 4-Digit Batch Code (found at the front, right part of AMEX card):_______________ Type of Card: (PLEASE CHECK) |__| VISA |__| MASTERCARD |__| Amexco Billing Address: _______________________________________________________________ Passport Number: _________________________________________ Birthdate: _______________________________________________ *Passport Number will be used as a proof of your identification as required by our approving bank. __________________________________________ Authorized Signature of Guest (same as in credit card) Please include photocopies of your credit card back to back and passport. Please fax back completed form to Infophil Inc at +63-2-895-5567. *********************************************************************** Should you need further assistance, please do not hesitate to email us. Thank you for using SmartShopper.Net! Sincerely, SmartShopper.NET Customer Care Email: support@smartshopper.net